NPASS Compound

Natural Product: NPC473172

Natural Product ID	NPC473172
Common Name ? The InCHIKey will be temporarily assigned as the "Common Name" if no IUPAC name or alternative short name is available.	PGQUPZCFLHXEHV-KPYCMCGFSA-N
IUPAC Name	n.a.
Synonyms
Synthetic Gene Cluster	n.a.
ChEMBL Identifier	CHEMBL3632953
PubChem CID	n.a.
Chemical Classification	CHEMONTID:0000000 [Organic compounds] [CHEMONTID:0000012] Lipids and lipid-like molecules [CHEMONTID:0000259] Prenol lipids [CHEMONTID:0001553] Triterpenoids

The Chemical Classification was calculated by Classyfire, a software for chemical taxonomy calculation. Reference: DOI:10.1186/s13321-016-0174-y.

Chemical Representations

RDKit 3D 81 84 0 0 0 0 0 0 0 0999 V2000 3.7816 -0.9447 -0.8199 O 0 0 0 0 0 0 0 0 0 0 0 0 4.5077 0.2028 -0.8784 C 0 0 2 0 0 0 0 0 0 0 0 0 5.7067 0.2238 0.0828 C 0 0 1 0 0 0 0 0 0 0 0 0 6.7872 -0.7328 -0.3073 C 0 0 0 0 0 0 0 0 0 0 0 0 7.0911 -0.5677 -1.6648 O 0 0 0 0 0 0 0 0 0 0 0 0 8.0322 -0.3166 0.5027 C 0 0 0 0 0 0 0 0 0 0 0 0 6.5532 -2.1665 0.0009 C 0 0 0 0 0 0 0 0 0 0 0 0 6.2593 1.5272 -0.1481 O 0 0 0 0 0 0 0 0 0 0 0 0 3.8053 1.4887 -0.8447 C 0 0 0 0 0 0 0 0 0 0 0 0 2.9545 1.8644 0.3521 C 0 0 2 0 0 0 0 0 0 0 0 0 1.8399 0.9304 0.6018 C 0 0 0 0 0 0 0 0 0 0 0 0 0.5330 1.0861 0.4432 C 0 0 0 0 0 0 0 0 0 0 0 0 -0.3702 2.1355 -0.0075 C 0 0 0 0 0 0 0 0 0 0 0 0 -1.6907 2.0126 -0.0203 C 0 0 0 0 0 0 0 0 0 0 0 0 -2.3019 0.7531 0.4411 C 0 0 2 0 0 0 0 0 0 0 0 0 -1.3822 -0.3759 0.0473 C 0 0 2 0 0 0 0 0 0 0 0 0 -0.1385 -0.1773 0.8399 C 0 0 1 0 0 0 0 0 0 0 0 0 0.9284 -1.2153 0.6958 C 0 0 0 0 0 0 0 0 0 0 0 0 2.0526 -0.4030 1.2317 C 0 0 0 0 0 0 0 0 0 0 0 0 2.9502 -0.6997 2.0005 O 0 0 0 0 0 0 0 0 0 0 0 0 -0.4165 -0.0387 2.3340 C 0 0 0 0 0 0 0 0 0 0 0 0 -1.0725 -0.2514 -1.4139 C 0 0 0 0 0 0 0 0 0 0 0 0 -1.9165 -1.7401 0.4025 C 0 0 0 0 0 0 0 0 0 0 0 0 -3.3232 -1.7191 0.9436 C 0 0 0 0 0 0 0 0 0 0 0 0 -4.1290 -0.8831 -0.0069 C 0 0 2 0 0 0 0 0 0 0 0 0 -3.7259 0.5724 0.0925 C 0 0 1 0 0 0 0 0 0 0 0 0 -4.5385 1.3147 1.1567 C 0 0 0 0 0 0 0 0 0 0 0 0 -4.1469 1.1774 -1.2294 C 0 0 0 0 0 0 0 0 0 0 0 0 -5.6078 1.0225 -1.4992 C 0 0 0 0 0 0 0 0 0 0 0 0 -6.2409 -0.1461 -0.9004 C 0 0 0 0 0 0 0 0 0 0 0 0 -7.4242 -0.3855 -1.1555 O 0 0 0 0 0 0 0 0 0 0 0 0 -5.5924 -1.1255 0.0241 C 0 0 0 0 0 0 0 0 0 0 0 0 -6.2137 -1.1617 1.3788 C 0 0 0 0 0 0 0 0 0 0 0 0 -5.8537 -2.4993 -0.6146 C 0 0 0 0 0 0 0 0 0 0 0 0 2.5070 3.3023 0.0476 C 0 0 0 0 0 0 0 0 0 0 0 0 4.1384 -1.6570 -0.2812 H 0 0 0 0 0 0 0 0 0 0 0 0 5.0055 0.1676 -1.9291 H 0 0 0 0 0 0 0 0 0 0 0 0 5.3495 0.1344 1.1059 H 0 0 0 0 0 0 0 0 0 0 0 0 6.7159 -1.3319 -2.1625 H 0 0 0 0 0 0 0 0 0 0 0 0 8.2440 0.7572 0.3683 H 0 0 0 0 0 0 0 0 0 0 0 0 7.7328 -0.4525 1.5781 H 0 0 0 0 0 0 0 0 0 0 0 0 8.8856 -0.9711 0.2530 H 0 0 0 0 0 0 0 0 0 0 0 0 6.1411 -2.7541 -0.8592 H 0 0 0 0 0 0 0 0 0 0 0 0 7.5675 -2.6612 0.1639 H 0 0 0 0 0 0 0 0 0 0 0 0 6.0277 -2.3350 0.9537 H 0 0 0 0 0 0 0 0 0 0 0 0 6.7270 1.4408 -1.0176 H 0 0 0 0 0 0 0 0 0 0 0 0 4.5484 2.3208 -0.9469 H 0 0 0 0 0 0 0 0 0 0 0 0 3.0883 1.5371 -1.7202 H 0 0 0 0 0 0 0 0 0 0 0 0 3.6133 1.9486 1.2522 H 0 0 0 0 0 0 0 0 0 0 0 0 0.0720 3.0558 -0.3588 H 0 0 0 0 0 0 0 0 0 0 0 0 -2.2398 2.8733 -0.3769 H 0 0 0 0 0 0 0 0 0 0 0 0 -2.2207 0.7971 1.5730 H 0 0 0 0 0 0 0 0 0 0 0 0 0.7192 -2.1007 1.3144 H 0 0 0 0 0 0 0 0 0 0 0 0 1.1385 -1.5418 -0.3155 H 0 0 0 0 0 0 0 0 0 0 0 0 -0.4928 1.0494 2.6172 H 0 0 0 0 0 0 0 0 0 0 0 0 0.4754 -0.3973 2.9174 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.2613 -0.6379 2.6757 H 0 0 0 0 0 0 0 0 0 0 0 0 0.0152 -0.4661 -1.6331 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.2420 0.7567 -1.8413 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.6121 -1.0241 -2.0368 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.2985 -2.2863 1.1335 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.9326 -2.3406 -0.5268 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.4150 -1.4250 1.9866 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.7077 -2.7742 0.8380 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.7846 -1.2035 -1.0387 H 0 0 0 0 0 0 0 0 0 0 0 0 -4.2878 2.4032 0.9836 H 0 0 0 0 0 0 0 0 0 0 0 0 -5.6042 1.2240 1.0414 H 0 0 0 0 0 0 0 0 0 0 0 0 -4.1263 1.0864 2.1529 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.8895 2.2436 -1.3371 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.6187 0.6441 -2.0736 H 0 0 0 0 0 0 0 0 0 0 0 0 -6.1630 1.9374 -1.1809 H 0 0 0 0 0 0 0 0 0 0 0 0 -5.7890 0.9657 -2.6138 H 0 0 0 0 0 0 0 0 0 0 0 0 -5.4975 -0.8790 2.1907 H 0 0 0 0 0 0 0 0 0 0 0 0 -7.1625 -0.5517 1.4465 H 0 0 0 0 0 0 0 0 0 0 0 0 -6.5569 -2.1968 1.6770 H 0 0 0 0 0 0 0 0 0 0 0 0 -6.9263 -2.4787 -0.9632 H 0 0 0 0 0 0 0 0 0 0 0 0 -5.8189 -3.2757 0.1681 H 0 0 0 0 0 0 0 0 0 0 0 0 -5.1962 -2.6728 -1.4684 H 0 0 0 0 0 0 0 0 0 0 0 0 1.8383 3.6584 0.8333 H 0 0 0 0 0 0 0 0 0 0 0 0 3.4180 3.9760 0.1452 H 0 0 0 0 0 0 0 0 0 0 0 0 2.1778 3.3737 -0.9708 H 0 0 0 0 0 0 0 0 0 0 0 0 1 2 1 0 2 3 1 0 3 4 1 0 4 5 1 0 4 6 1 0 4 7 1 0 3 8 1 0 2 9 1 0 9 10 1 0 10 11 1 0 11 12 2 0 12 13 1 0 13 14 2 0 14 15 1 0 15 16 1 0 16 17 1 0 17 18 1 0 18 19 1 0 19 20 2 0 17 21 1 1 16 22 1 6 16 23 1 0 23 24 1 0 24 25 1 0 25 26 1 0 26 27 1 1 26 28 1 0 28 29 1 0 29 30 1 0 30 31 2 0 30 32 1 0 32 33 1 0 32 34 1 0 10 35 1 0 19 11 1 0 32 25 1 0 17 12 1 0 26 15 1 0 1 36 1 0 2 37 1 6 3 38 1 1 5 39 1 0 6 40 1 0 6 41 1 0 6 42 1 0 7 43 1 0 7 44 1 0 7 45 1 0 8 46 1 0 9 47 1 0 9 48 1 0 10 49 1 1 13 50 1 0 14 51 1 0 15 52 1 1 18 53 1 0 18 54 1 0 21 55 1 0 21 56 1 0 21 57 1 0 22 58 1 0 22 59 1 0 22 60 1 0 23 61 1 0 23 62 1 0 24 63 1 0 24 64 1 0 25 65 1 6 27 66 1 0 27 67 1 0 27 68 1 0 28 69 1 0 28 70 1 0 29 71 1 0 29 72 1 0 33 73 1 0 33 74 1 0 33 75 1 0 34 76 1 0 34 77 1 0 34 78 1 0 35 79 1 0 35 80 1 0 35 81 1 0 M END

Standard InCHIKey	PGQUPZCFLHXEHV-KPYCMCGFSA-N
Standard InCHI	InChI=1S/C30H46O5/c1-17(15-19(31)25(34)27(4,5)35)24-18-9-10-22-28(6)13-12-23(33)26(2,3)21(28)11-14-29(22,7)30(18,8)16-20(24)32/h9-10,17,19,21-22,25,31,34-35H,11-16H2,1-8H3/t17-,19+,21+,22+,25+,28+,29+,30+/m1/s1
SMILES	O[C@H]([C@@H](C(O)(C)C)O)C[C@H](C1=C2C=C[C@@H]3[C@]([C@]2(CC1=O)C)(C)CC[C@@H]1[C@]3(C)CCC(=O)C1(C)C)C

Calculated Properties

Physi-Chem Properties

Molecular Weight:	486.33	Volume:	526.615 ? Van der Waals volume.
Dense:	0.924	LogP:	3.192 ? The logarithm of the n-octanol/water distribution coefficients.
logD7.4:	3.293 ? The logarithm of the n-octanol/water distribution coefficient at pH=7.4.	LogS:	-4.868 ? The logarithm of aqueous solubility value.
Rotatable Bonds:	5.0	Rigid Bonds:	22.0
TPSA:	94.83 ? Topological Polar Surface Area.	H-Bond Acceptor:	5.0
H-Bond Donor:	3.0	Rings:	4.0
Heavy Atoms:	5.0

MedChem Properties

QED Drug-Likeness Score:	0.52	GASA:	1.0 ? GASA represents the probability of being difficult to synthesize, ranging from 0 to 1.
Synthetic Accessibility Score:	5.185	Fsp³:	0.8
MCE-18:	86.667 ? MCE-18 stands for medicinal chemistry evolution.MCE-18≥45 is considered a suitable value.	Lipinski Rule-of-5:	Rejected
Pfizer Rule:	Rejected	GSK Rule:	Accepted
Golden Triangle Rule:	Rejected	BMS Rule:	0
Chelating Alert:	0	PAINS Alert:	0
Colloidal aggregators:	0.597	Fluc inhibitor:	0.016 ? The fluc inhibitor value is the probability of being fLuc inhibitors, within the range of 0 to 1.
Blue fluorescence:	0.406 ? The blue fluorescence value is the probability of being blue fluorescence, within the range of 0 to 1	Green fluorescence:	0.001 ? The green fluorescence value is the probability of being green fluorescence, within the range of 0 to 1
Reactive compounds:	0.326	Promiscuous compounds:	0.315

ADMET Properties (ADMETlab3.0)

ADMET: Absorption

Caco-2 Permeability:	-4.892	MDCK Permeability:	-4.759
Pgp-inhibitor:	0.264	Pgp-substrate:	0.069
PAMPA:	0.78 ? The experimental data for Peff was logarithmically transformed (logPeff). Molecules with log Peff values below 2.0 were classified as low-permeability (Category 0), while those with log Peff values exceeding 2.5 were classified as high-permeability (Category 1).	Human Intestinal Absorption (HIA):	0.001
20% Bioavailability (F20%):	0.01	30% Bioavailability (F30%):	0.044
50% Bioavailability (F50%):	0.987

ADMET: Distribution

Blood-Brain-Barrier Penetration (BBB):	0.007	MRP1:	0.938
Plasma Protein Binding (PPB):	91.412%	Volume Distribution (VD):	0.098
Fu:	12.15% ? The fraction unbound in plasms.	OATP1B1 inhibitor:	0.999
OATP1B3 inhibitor:	1.0	BCRP inhibitor:	0.471
BSEP inhibitor:	0.993

ADMET: Metabolism

CYP1A2-inhibitor:	0.236	CYP1A2-substrate:	0.009
CYP2C19-inhibitor:	0.848	CYP2C19-substrate:	0.032
CYP2C9-inhibitor:	0.0	CYP2C9-substrate:	0.0
CYP2D6-inhibitor:	0.0	CYP2D6-substrate:	0.01
CYP3A4-inhibitor:	0.993	CYP3A4-substrate:	0.955
CYP2B6-substrate:	0.0	CYP2C8-inhibitor:	1.0
HLM stability:	0.727 ? Human liver microsomal (HLM) stability. Category 0: stable+ (HLM > 30 min); Category 1: unstable- (HLM ≤ 30 min). The output value is the probability of human liver microsomal instability, where a value closer to 1 indicates a higher likelihood of instability.

ADMET: Excretion

Clearance (CL):

8.657

Half-life (T1/2):

0.66

ADMET: Toxicity

hERG Blockers:	0.03	hERG Blockers (10um):	0.167
Human Hepatotoxicity (H-HT):	0.579	Drug-induced Liver Injury (DILI):	0.204
AMES Toxicity:	0.566	Rat Oral Acute Toxicity:	0.461
Maximum Recommended Daily Dose:	0.736	Skin Sensitization:	0.963
Carcinogencity:	0.896	Eye Corrosion:	0.02
Eye Irritation:	0.494	Respiratory Toxicity:	0.76
Drug-induced Neurotoxicity:	0.444	Ototoxicity:	0.399
Hematotoxicity:	0.804	Drug-induced Nephrotoxicity:	0.96
Genotoxicity:	0.947	RPMI-8226 Immunitoxicity:	0.164
A549 Cytotoxicity:	0.171	Hek293 Cytotoxicity:	0.448
BCF:	0.713 ? Bioconcentration factors are used for considering secondary poisoning potential and assessing risks to human health via the food chain. The unit is -log10[(mg/L)/(1000*MW)].	IGC50:	3.5 ? 48 hour Tetrahymena pyriformis IGC50. The unit of IGC50 is -log10[(mg/L)/(1000*MW)].
LC50DM:	5.234 ? 48 hour Daphnia magna LC50. The unit of LC50DM is -log10[(mg/L)/(1000*MW)].	LC50FM:	4.489 ? 96 hour fathead minnow LC50. The unit of LC50FM is -log10[(mg/L)/(1000*MW)].

Species Source

Organism ID	Organism Name	Taxonomy Level	Family	SuperKingdom	Isolation Part	Collection Location	Collection Time	Reference
NPO30648	Alisma orientale	Species	Alismataceae	Eukaryota	rhizome	n.a.	n.a.	PMID[10560729]
NPO30648	Alisma orientale	Species	Alismataceae	Eukaryota	n.a.	rhizome	n.a.	PMID[17541191]
NPO30648	Alisma orientale	Species	Alismataceae	Eukaryota	Rhizome	n.a.	n.a.	PMID[26425784]
NPO30648	Alisma orientale	Species	Alismataceae	Eukaryota	n.a.	tuber	n.a.	PMID[26666273]
NPO30648	Alisma orientale	Species	Alismataceae	Eukaryota	n.a.	n.a.	n.a.	Database[COCONUT]
NPO30648	Alisma orientale	Species	Alismataceae	Eukaryota	n.a.	n.a.	n.a.	Database[HerDing]

Note for Reference:
In addition to directly collecting NP source organism data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated them from below databases:
☉ UNPD: Universal Natural Products Database [PMID: 23638153].
☉ StreptomeDB: a database of streptomycetes natural products [PMID: 33051671].
☉ TM-MC: a database of medicinal materials and chemical compounds in Northeast Asian traditional medicine [PMID: 26156871].
☉ TCM@Taiwan: a Traditional Chinese Medicine database [PMID: 21253603].
☉ TCMID: a Traditional Chinese Medicine database [PMID: 29106634].
☉ TCMSP: The traditional Chinese medicine systems pharmacology database and analysis platform [PMID: 24735618].
☉ HerDing: a herb recommendation system to treat diseases using genes and chemicals [PMID: 26980517].
☉ MetaboLights: a metabolomics database [PMID: 27010336].
☉ FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].

NP Quantity Composition/Concentration

Organism ID	Organism Name	Organism Material Preparation	Organism Part	NP Quantity (Standard)	NP Quantity (Minimum)	NP Quantity (Maximum)	Quantity Unit	Reference

Note for Reference:
In addition to directly collecting NP quantitative data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated NP quantitative records for specific NP domains (e.g., NPS from foods or herbs) from domain-specific databases. These databases include:
☉ DUKE: Dr. Duke's Phytochemical and Ethnobotanical Databases.
☉ PHENOL EXPLORER: is the first comprehensive database on polyphenol content in foods [PMID: 24103452], its homepage can be accessed at here.
☉ FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].

Biological Activity

Activity Type	# Activity
IC50	1

Activity Type	# Activity
Individual protein	1

Molecular-level activity

Target ID	Target Type	Target Name	Target Organism	Activity Type	Activity Relation	Value	Unit	Reference
NPT203	Individual protein	Carboxylesterase 2	Homo sapiens	IC50	=	22740.0	nM	PMID[10879539]

In vitro activity

Target ID	Target Type	Target Name	Target Organism	Activity Type	Activity Relation	Value	Unit	Reference

In vivo activity

Target ID	Target Type	Target Name	Target Organism	Activity Type	Activity Relation	Value	Unit	Reference

Experimental ADME

Experiment Model	Experiment Tissue	ADME Type	ADME Relation	ADME Value	ADME Unit	Reference

Experimental Toxicity

Quantitative toxicity

Experiment Model	Experiment Organism	Toxicity Type	Toxicity Relation	Toxicity Value	Toxicity Unit	Reference

Common Abbreviations:
LC: Lethal Concentration; LD: Lethal Dose; LT:Lethal Time; NOAEL: No-observed-adverse-effect Level; BMDL: Benchmark Dose Lower Confidence Limit; BMD: Benchmark Dose; BMC:Benchmark Concentration; LOAEL: Lowest Observed Adverse Effect Level; RfD:Reference Dose; RfC:Reference Concentration; MRL: Minimal Risk Level; MEG: Maximum Exposure Guideline; PAC: Protective Action Criteria

Categorical toxicity labels

Hepatotoxicity	Carcinogenicity	Mutagenicity	Cardiotoxicity	Respiratory Toxicity	Eye Irritation	Endocrine Disruption

Note for Reference:
In addition to directly collecting NP quantitative data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated NP toxicity records from domain-specific databases. These databases include:
☉ ToxValDB: a curated database that compiles quantitative toxicity values for chemicals from diverse public sources to support toxicological research and risk assessment.
☉ TOXRIC: a comprehensive, free-to-access, online database providing toxicological/feature data. The toxicity labels are retrieved from this database. [PMID: 36400569]

Chemically structural similarity

Similar Active Natural Products in NPASS

Top-200 similar NPs were calculated against the active-NP-set (includes approximately 50,000 NPs with experimentally-derived bioactivity available in NPASS)

Similarity is measured using the Tanimoto coefficient (Tc) , which compares the binary fingerprints of two molecules. Tc is calculated as the intersection divided by the union of '1' bits in the fingerprints, ranging from 0 to 1, with 1 indicating highest similarity.

● The left chart: Distribution of similarity level between NPC473172 and all remaining natural products in the NPASS database.
● The right table: Most similar natural products (Tc>=0.5 or Top200).

range	Tanimoto Coefficient
0-0.1	16577
0.1-0.2	29269
0.2-0.3	3713
0.3-0.4	257
0.4-0.5	27
0.5-0.6	9
0.6-0.7	2
0.7-0.8	0
0.8-0.85	1
0.85-0.9	1
0.9-0.95	0
0.95-1	0

Similarity Score	Similarity Level	Natural Product ID
0.8644	High Similarity	NPC473162
0.8167	Intermediate Similarity	NPC473161
0.7705	Intermediate Similarity	NPC473164
0.7538	Intermediate Similarity	NPC473163
0.661	Remote Similarity	NPC473171
0.6471	Remote Similarity	NPC471582
0.5942	Remote Similarity	NPC473174
0.5493	Remote Similarity	NPC473169
0.5217	Remote Similarity	NPC469314
0.5217	Remote Similarity	NPC469317
0.5217	Remote Similarity	NPC241875
0.5147	Remote Similarity	NPC86370
0.5143	Remote Similarity	NPC469325
0.5132	Remote Similarity	NPC473175
0.507	Remote Similarity	NPC473167

Similar Clinical/Approved Drugs

Similarity level is defined by Tanimoto coefficient (Tc) between two molecules.

● The left chart: Distribution of similarity level between NPC473172 and all drugs/candidates.
● The right table: Most similar clinical/approved drugs (Tc>=0.5 or Top200).

range	Tanimoto Coefficient
0-0.1	6491
0.1-0.2	2532
0.2-0.3	127
0.3-0.4	0
0.4-0.5	0
0.5-0.6	0
0.6-0.7	0
0.7-0.8	0
0.8-0.85	0
0.85-0.9	0
0.9-0.95	0
0.95-1	0

Similarity Score	Similarity Level	Drug ID	Developmental Stage
		NPD

Bioactivity similarity

Similar Natural Products in NPASS

Similarity level is defined by Bioactivity similarity was calculated based on bioactivity descriptors of compounds. The bioactivity descriptors were calculated by a recently developed AI algorithm Chemical Checker (CC) [Nature Biotechnology, 38:1087–1096, 2020; Nature Communications, 12:3932, 2021], which evaluated bioactivity similarities at five levels:
☉ A: chemistry similarity;
☉ B: biological targets similarity;
☉ C: networks similarity;
☉ D: cell-based bioactivity similarity;
☉ E: similarity based on clinical data.
Those 5 categories of CC bioactivity descriptors were calculated and then subjected to manifold projection using UMAP algorithm, to project all NPs on a 2-Dimensional space. The current NP was highlighted with a small circle in the 2-D map. Below figures: left-to-right, A-to-E.

A: chemistry similarity

B: biological targets similarity

C: networks similarity

D: cell-based bioactivity similarity

E: similarity based on clinical data